Elevated liver enzymes as a predictor of liver injury in stable blunt abdominal trauma patients: case report and systematic review of the literature

Liver injury secondary to blunt abdominal trauma is a well-defined entity in emergency medicine. A challenge exists in the diagnosis of liver trauma in the stable, well-appearing patient with a history of blunt abdominal trauma. In centres lacking advanced diagnostic modalities an elevation in hepatic transaminases may provide guidance for the rural emergency physician in seeking further imaging and/or surgical consultation. We present a case report and a discussion of the literature. The literature provided a broad spectrum of results. There appears to be a direct relationship between blunt liver trauma and elevation in liver transaminases. These results are especially evident in the pediatric population. Our findings may help guide the rural emergency physician in transfer and disposition decisions in patients in this situation.